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The Zepbound KwikPen can feel a little intimidating the first time you hold it. The device has several parts, and you need to prime it before each weekly injection. But once you learn the routine, the steps become much easier to follow.

Below, you’ll find step-by-step instructions and photos that show exactly how to prepare, prime, inject, store, and troubleshoot your Zepbound KwikPen.

Key Takeaways

  • Zepbound KwikPen is for one person only. Do not share it, even if you change the needle.
  • Always attach a new compatible pen needle before each injection, and prime the pen before every weekly dose.
  • Throw away the pen after 4 weekly doses or 30 days after first use, even if medicine remains.

What you need before your Zepbound KwikPen injection

Gather everything before you start. You will need the following:

    • your Zepbound KwikPen
    • a compatible pen needle
    • an alcohol swab, gauze, or a cotton ball
    • an FDA-cleared sharps disposal container or suitable household sharps container

Needles are not included with the pen, so ask your pharmacist or healthcare provider which pen needle to use.

The Zepbound KwikPen works with ISO 11608-2 compliant pen needles, including needles from Embecta (formerly BD), Novo Nordisk, and Terumo. Compatible needles are available in various lengths, ranging from 4 mm to 12.7 mm, and gauges from 29G to 34G.

Studies and clinical guidelines highly recommend 32G x 4 mm needles for subcutaneous injections. Research demonstrates they successfully deliver medication into the fat layer for patients of all body types while minimizing pain and reducing the risk of accidental intramuscular injection.

Before each injection, check the label. Make sure the medicine name and dose strength match your prescription. Do not use the pen if it is expired, damaged, frozen, cloudy, discolored, or has particles. Zepbound should look colorless to slightly yellow.

How to attach a new needle to a Zepbound KwikPen

Follow these steps in order.

Hands being washed with soap and water before preparing a Zepbound KwikPen injection.

Step 1: Wash your hands

Wash your hands with soap and water. Start with clean hands before touching the pen, needle, or injection site. This simple step helps keep the process clean.

Hands removing the cap from a Zepbound KwikPen and checking the medication.

Step 2: Remove the cap and inspect the pen

Gently twist the cap back and forth. Then pull it straight off. Do not yank the cap at an angle.

After removing the cap, inspect the pen and label. Look at the medicine through the cartridge. Do not use the pen if anything looks wrong, if the pen is expired, or if the medicine is cloudy, discolored, frozen, or has particles.

Hands wiping the red inner seal of a Zepbound KwikPen with an alcohol swab.

Step 3: Wipe the red inner seal

Use an alcohol swab to wipe the red inner seal at the end of the pen. This is the area where the pen needle attaches.

Hands removing the paper tab from a new pen needle before attaching it to a Zepbound KwikPen.

Step 4: Use a new pen needle

Choose a new compatible pen needle every time. A new needle helps reduce the risk of infection and blocked needles. Pull off the paper tab from the outer needle shield.

Hands attaching a pen needle to a Zepbound KwikPen.

Step 5: Attach the pen needle

Push the capped pen needle straight onto the pen. Twist it until it feels tight. Try to attach it straight, not at an angle. Proper needle use helps the medicine flow as intended.

Hands removing the outer and inner needle shields from a Zepbound KwikPen needle.

Step 6: Remove both needle shields

Remove the outer and inner needle shields from Zepbound KwikPen

Keep the outer needle shield. You will use it later when removing the needle. Then pull off the inner needle shield and throw it in your household trash.

How to prime Zepbound KwikPen

Do not skip priming because this removes air from the cartridge and checks that the pen works correctly. During priming, you release a small amount of medicine into the air. Do not inject into your body during this step.

Close-up of a Zepbound KwikPen dose window set to the priming position.

Step 7: Dial to the prime position

Slowly turn the dose knob until you hear 2 clicks and see the extended line in the dose window. This is the prime position. You can turn the dose knob in either direction if you need to line up the prime mark with the dose indicator.

Hands holding a Zepbound KwikPen upright while tapping the cartridge holder.

Step 8: Hold the pen up and tap the cartridge

Hold your Zepbound KwikPen with the needle pointing up. Gently tap the cartridge holder. This moves air bubbles toward the top, so they can leave during priming.

Zepbound KwikPen being primed with a small drop of medication visible at the needle tip.

Step 9: Release a small drop into the air

Push the dose knob in until it stops. Keep holding it in and slowly count to 5. The “0” icon must appear in the dose window. A small drop of medicine at the needle tip means the pen is primed. You do not need to see a stream.

If you do not see medicine, repeat the priming steps no more than 2 extra times. If you still do not see medicine, change the pen needle and repeat the priming steps no more than 1 more time. If no medicine appears after that, contact Lilly at 1-800-LillyRx, which is 1-800-545-5979.

How to inject Zepbound with KwikPen

Once the pen is primed, you can inject your weekly dose. Move calmly and do not rush the dose knob. Pressing slowly may make the injection easier.

Diagram of the recommended injection sites of the Zepbound KwikPen (abdomen, thigh, or back of the upper arm).

Step 10: Choose and rotate your injection site

You can inject Zepbound in your thigh or stomach area. Stay at least 2 inches away from your belly button. You can also inject in the back of your upper arm, but it’s best to ask for help from a friend or family member for this injection site.

Rotate your injection site each week. You may use the same general body area, but choose a different spot within that area.

Hands dialing a Zepbound KwikPen to the correct weekly dose.

Step 11: Dial your weekly dose

Turn the dose knob all the way until it stops, and the “1” icon appears in the dose window. This is your weekly dose. Do not count clicks when selecting your dose. The dose window must show the “1” icon.

Hands injecting Zepbound with a KwikPen and holding the dose button during administration.

Step 12: Insert the needle and inject

Insert the needle into your skin. Push the dose knob in until it stops. Keep holding the dose knob in and slowly count to 5. Wait for the “0” icon to appear in the dose window before you remove the needle.

Zepbound KwikPen after injection with the completed dose indicator visible in the dose window.

Step 13: Remove the needle and check the dose window

Confirm the “0” icon on Zepbound KwikPen and pull the needle out of your skin. A drop of medicine on the needle tip is normal and does not affect your dose. Check the dose window again. If you see the “0” icon, you received the full dose.

If you do not see the “0” icon, insert the needle back into your skin and finish the injection. Do not redial the dose. If you still think you did not receive the full dose, do not start over and do not repeat the injection. Contact your healthcare provider or Lilly for help.

What to do after your Zepbound KwikPen injection

The aftercare steps help prevent rubbing, leaking, blocked needles, and accidental needle sticks.

Illustration showing gauze lightly pressed on the injection site with a reminder not to rub.

Step 14: Press gently if you see blood

If you see blood after you remove the needle, lightly press the injection site with gauze or a cotton ball. Do not rub the area.

Illustration showing the outer needle shield carefully replaced over the used needle.

Step 15: Put the outer needle shield back on

Carefully replace the outer needle shield. Use care during this step because the needle has been used.

Illustration showing the capped needle unscrewed from the KwikPen and placed into a sharps container.

Step 16: Remove and discard the capped needle

Unscrew the capped needle from Zepbound KwikPen. Put the used needle in a sharps disposal container right away.

Do not store the pen with the needle attached. This helps prevent leaking, needle blockage, and air entering the pen.

If you do not have an FDA-cleared sharps disposal container, you may use a household container that is:

    • made of a heavy-duty plastic,
    • can be closed with a tight-fitting,
    • puncture-resistant lid,
    • without sharps being able to come out,
    • upright and stable during use,
    • leak-resistant, and
    • properly labeled to warn of hazardous waste inside the container.

When your sharps disposal container is almost full, follow your community guidelines for the right way to dispose of your sharps disposal container. There may be state or local laws about how you should throw away (discard) used needles.

Hands placing the cap back onto a Zepbound KwikPen after use.

Step 17: Replace the pen cap

Put the pen cap back on. Do not store the pen without the cap attached.

You may store your used KwikPen at room temperature up to 86°F (30°C) after your injection. Keep away from heat and light, and out of the sight and reach of children.

Throw away the Pen after receiving 4 weekly doses or 30 days after first use, even though the pen has medicine left in it. Attempting to inject any leftover medicine could result in an incomplete dose even though the pen still has medicine left in it.

How to troubleshoot a Zepbound KwikPen if the dose knob is hard to push

If the Zepbound KwikPen dose knob feels hard to push, do not force it. Lilly explains that this can happen for several reasons, including:

    • a blocked or incompatible needle,
    • dirt or liquid inside the pen, or
    • pressing the dose knob too quickly.

Here is a step-by-step way to troubleshoot it.

1. Stop and inspect the pen

First, pause before continuing. Look over the pen carefully.

Check that:

    • The pen is not cracked, damaged, or leaking.
    • The red inner seal is intact.
    • The pen has not been exposed to dirt, dust, food residue, or liquid.

Dirt, dust, food residue, or liquid inside the KwikPen can make the mechanism difficult to push. If the pen has been exposed to those things, Eli Lilly advises throwing it away and using a new one.

2. Check the needle

A hard-to-push dose knob often points to a problem with the needle. Lilly says the needle may be faulty, jammed, blocked, damaged, bent, broken, or not compatible with the pen.

Make sure:

    • You attached a new compatible pen needle.
    • The needle is screwed on securely.
    • The needle went straight onto the pen, not at an angle.
    • The needle is not bent, broken, or damaged.

If the needle is blocked, medicine may not flow properly. That can make the dose knob feel stuck or very hard to press.

3. Replace the needle and prime again

If you think the needle may be the problem, remove it safely and attach a new compatible pen needle.

Then prime the pen again.

Lilly says to prime the KwikPen before each injection because priming removes air from the cartridge and helps confirm that the pen is working correctly. A small amount of medicine at the needle tip is enough. You do not need to see a stream of medicine.

4. Press the dose knob more slowly

Do not push the dose knob quickly or forcefully.

Lilly specifically says that pushing the dose knob too quickly can make it harder to inject. Pressing it more slowly may make the injection easier.

A good technique is:

    • Insert the needle as instructed.
    • Put your thumb on the dose knob.
    • Press the dose knob slowly until it stops.
    • Keep holding it while you count to 5.

5. Do not press the dose knob without a needle attached

Lilly warns that you should only press the dose knob when a compatible pen needle is attached. If medicine flow is blocked, pressure can build inside the cartridge. This may cause the red inner seal to bulge and may waste medicine once a needle is attached.

6. Think about whether the pen has already been used up

If the pen has already delivered 4 full doses, or if it has been primed too many times, the pen may no longer work as expected.

If you have received 4 full doses or over-primed the pen, you should throw the KwikPen away in a sharps disposal container and use a new KwikPen.

7. If the mechanism seems clogged, discard the pen

If the needle has been changed, the pen has been checked, and the dose knob is still hard to push, the pen mechanism may be clogged. Lilly’s guidance is to throw the KwikPen away in a sharps disposal container and get a new KwikPen.

Do not:

    • Force the dose knob.
    • Reuse an old needle.
    • Use a bent, damaged, or incompatible needle.
    • Press the dose knob without a needle attached.
    • Keep using a pen that has dirt, food, dust, or liquid inside it.
    • Try to repair the pen yourself.
    • Repeat a dose unless your healthcare professional tells you to.

How to troubleshoot Zepbound KwikPen if it will not dial to the 1 icon

If the dose knob will not reach the 1 icon, do not inject.

The 1 icon is the weekly dose setting. If the pen stops before reaching 1, it may not be able to deliver a full weekly dose. Forcing the dose knob will not fix the problem and may lead to an incomplete dose.

1. Check whether you already used all 4 doses

Each Zepbound KwikPen contains 4 doses, and each dose delivers a fixed 0.6 mL of solution. The pen also contains extra medicine for priming before each injection. You should expect to see some medicine left in the pen after the 4th dose, but this leftover liquid is not a full dose.

If the pen has already delivered its 4 complete doses, start a new KwikPen for your next weekly dose.

2. Do not use the cartridge lines to count doses

The lines on the KwikPen are not meant to show how many doses are left. Lilly explains that the lines should not be used as a dose counter. They may show the approximate plunger position, but they do not tell you that another dose remains.

This is important because people may see liquid in the cartridge and assume they still have a full dose. After the 4th dose, there may still be leftover medicine, but it is not intended to be injected as an extra dose.

A photo shared on Reddit shows what Zepbound KwikPen looks like at different stages of use. As each dose is used, the internal plunger gradually moves through the cartridge.

Comment
byu/Fresh_Fox_8118 from discussion
inZepbound

3. Check whether the pen may have been over-primed

Priming uses a small amount of medicine. The pen includes enough extra solution for normal priming before each dose, but over-priming can cause you to lose the 4th dose.

This may happen if you:

    • Repeat priming too many times.
    • Hold the dose knob too long during priming.
    • Prime even after a drop has already appeared.
    • Mistake priming for a failed dose and keep repeating it.

If the pen will not dial to 1, and you know you have not taken all 4 injections, over-priming may be the reason there is not enough medicine left for a full dose.

4. Review whether you primed correctly

To prime the Zepbound KwikPen, slowly turn the dose knob until you hear 2 clicks and the extended line appears in the dose window. That is the prime position. You can adjust the dose knob in either direction until the prime position is reached.

The pen is successfully primed when a small amount of medicine comes out of the needle tip. You do not need to see a stream of medicine. A small drop is enough.

5. Get help if you are unsure

If you are still having trouble or are not sure whether you received a full dose, contact Lilly at 1-888-545-5972 or ask your doctor.

Summary

Using the Zepbound KwikPen follows the same routine each week. You wash your hands, inspect the pen, attach a new needle, prime the pen, dial to your weekly dose, and inject. Then remove and discard the used needle safely.

The most common problems are usually tied to the needle, priming, or the dose knob. If something does not look or feel right, check the Instructions for Use, contact your healthcare provider, or call Lilly at 1-800-LillyRx.

Frequently Asked Questions

No. The instructions say not to redial or repeat an injection if you are unsure you received the full dose. If something seems wrong, contact your healthcare provider or Lilly instead of trying to reset the device.

Do not try to repair the pen. If the dose knob is hard to push, press more slowly, change to a new pen needle and prime again, or discard the pen if dust, food, or liquid may be inside it. For ongoing problems, contact your healthcare provider or call Lilly at 1-800-LillyRx.

The pen is finished after 4 weekly doses, even if liquid remains inside. The pen may also block you from dialing a full dose when there is not enough medicine left.

For priming, you slowly turn the dose knob until you hear 2 clicks and see the extended line in the dose window. For the weekly dose, do not count clicks. Turn the dose knob all the way until it stops, and the 1 icon appears in the dose window. If you’re interested in click-based dosing calculations, you can use our GLP-1 Click Calculator, but always follow your healthcare provider’s instructions and the official prescribing information for your medication.

You should press the dose knob steadily until it stops, then keep holding it while slowly counting to 5. If it feels hard to push, pressing more slowly may help. A blocked needle can also cause this, so you may need a new pen needle and to prime again.

The Zepbound KwikPen works with ISO 11608-2 compliant pen needles, including needles from Embecta (formerly BD), Novo Nordisk, and Terumo. Compatible needles are available in various lengths, ranging from 4 mm to 12.7 mm, and gauges from 29G to 34G. Studies and clinical guidelines highly recommend 32G x 4 mm needles for subcutaneous injections.

Yes. Priming removes air from the cartridge and checks that the pen works properly. A small drop at the needle tip means the pen has been primed.

After opening, the Zepbound KwikPen is good for 30 days. You should also discard it after 4 weekly doses, whichever comes first.

Unused Zepbound KwikPens should be stored in the refrigerator at 36°F to 46°F. After use, the pen may be refrigerated or kept at room temperature up to 86°F, away from heat and light. It’s also important not to freeze it.

It really depends on your preference, comfort level, and what your prescriber recommends. The Zepbound KwikPen contains 4 fixed weekly doses in one pen and requires attaching a new compatible pen needle for each injection. A single-dose pen is used once and may feel simpler for people who prefer fewer preparation steps. Your doctor can help you decide between the Zepbound KwikPen and the single-dose pen.

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Sources

INSTRUCTIONS FOR USE. https://pi.lilly.com/us/zepbound-kwikpen-us-ifu.pdf

Difficulty turning the dose knob of Zepbound® KwikPen® | Lilly Canada. (n.d.). https://www.lilly.com/en-ca/medicines/medicine-faqs/zepbound-kwikpen/dose-knob

What should I do if Zepbound KwikPen is jammed? | Lilly Canada. (n.d.). https://www.lilly.com/en-ca/medicines/medicine-faqs/zepbound-kwikpen/jammed